Does Medicaid Cover Dental in Maryland: Adults, Kids, and Limits

Yes, Medicaid does cover dental care in Maryland. Both adults and children enrolled in full Medicaid receive dental benefits through the Maryland Healthy Smiles Dental Program at no cost, with no premiums, deductibles, copays, or annual benefit cap.¹ Children under 21 have long had broad coverage; adults 21 and older gained comprehensive dental benefits on January 1, 2023.²

What Adults 21 and Older Get

If you are 21 or older and carry a red and white Medicaid card, you qualify for dental care through Maryland Healthy Smiles. Covered services include routine checkups, cleanings, fluoride treatments, and X-rays on the preventive side, along with fillings, crowns, and root canals for restorative work. Extractions, anesthesia, and adjustments to existing dentures are also covered.¹

You should never be billed by a participating dentist for a covered procedure. If a provider asks you to pay out of pocket for something that falls within the benefit, that’s a sign something is wrong with the billing.

What Children and Young Adults Under 21 Get

Enrollees under 21 receive the broadest dental coverage in the program. Federal Medicaid law requires every state to cover medically necessary dental care for this age group through the Early and Periodic Screening, Diagnostic, and Treatment benefit, including care to relieve pain, restore teeth, and maintain oral health.³

Beyond everything adults receive, children get fluoride varnish, dental sealants, and orthodontic treatment when it is medically necessary.¹⁴⁵

What Maryland Medicaid Will Not Pay For

Three categories of dental work are excluded from coverage:

Full dentures for adults 21 and older. Adjustments to existing dentures are covered, but new full dentures are not.
Cosmetic procedures performed solely to improve appearance rather than treat a medical condition.
Experimental procedures that aren’t yet established as standard practice.

The denture exclusion is the one that catches most adults off guard. Partial dentures for children under 21 can be covered with prior authorization, but adults who need full dentures will need to look elsewhere, such as community health centers or dental schools that offer reduced-cost services.¹

Frequency Limits on Routine Services

There is no annual dollar cap on benefits, but individual services are capped by how often they can be done:

Cleanings: one every six months
Dental exams: one every six months
Bitewing X-rays: one set every six months, for ages 2 through 25
Full-mouth X-rays: one set every three years
Panoramic X-rays: one every three years, for ages 6 through 25 in non-orthodontic cases

A comprehensive or detailed exam is limited to once per lifetime per provider location, so switching dentists may be the only way to get another one covered. Services needed more often than these schedules allow can still be covered if your dentist documents medical necessity.⁵

Services That Need Prior Authorization

Some procedures require your dentist to get approval from the program administrator before performing the work. The dental office handles the paperwork, but it can add days or weeks before treatment starts. Services currently requiring prior authorization include:

Crowns of any type
Root canals on permanent teeth
Periodontal (gum) therapy
Partial and complete dentures
All orthodontic services, including braces and retainers
Oral surgery such as cleft palate treatment and biopsies
Dental procedures done in a hospital outpatient setting or ambulatory surgical center

Cleanings, exams, fillings, simple extractions, and routine X-rays generally do not need prior authorization. If a service you need is denied, you have the right to appeal that decision through the Maryland Medicaid program.⁵

Finding a Dentist Who Accepts Medicaid

Not every dentist in Maryland participates in Medicaid, so confirm before scheduling. A few ways to find one:

Search by location at member.mdhealthysmiles.com.
Call Maryland Healthy Smiles Member Services at 1-855-934-9812 for help finding a provider, understanding benefits, or changing your dental home.
Use the Maryland Department of Health’s Provider Finder at health.maryland.gov, where every listed provider accepts Medicaid.
Check your Member ID card for an assigned dental home. You can still see any dentist in the Maryland Healthy Smiles network.

If online searches turn up providers not taking new patients, calling Member Services directly often works better.¹⁶

A Change Coming in Early 2026

In early 2026, DentaQuest is replacing SKYGEN USA as the company that administers the Maryland Healthy Smiles Dental Program. The benefits themselves are not changing. You will receive a notice in the mail about the transition, and until DentaQuest takes over, your current coverage and provider network stay the same through SKYGEN USA.¹

1
Maryland Department of Health. Maryland Healthy Smiles Dental Program
2
Maryland Department of Legislative Services. 2023 Report on Dental Provider Participation in Maryland Healthy Smiles
3
Medicaid.gov. Early and Periodic Screening, Diagnostic, and Treatment
4
Cornell Law Institute. Maryland Code of Regulations COMAR 10.09.05.04 – Covered Services
5
Insure Kids Now. Summary of Benefits Report for Maryland, Medicaid
6
Maryland Department of Health. Provider Finder